In 2013, an outbreak of wild poliovirus type 1 (WPV1) began in the Horn of Africa. Six cases have been confirmed, four from Somalia (Banadir and Bay region) and two from Kenya (Dadaab in north-‐eastern Kenya). The first case was confirmed in Somalia on 9 May 2013 and in Kenya on 22 May. This was the first outbreak in Somalia since 2007 and in Kenya since 2011. Outbreak campaigns have been launched in both countries. Immunization campaigns are planned and being conducted in neighboring Ethiopia and Yemen to boost population immunity levels and minimize the risk of spread of the outbreak. (Global Polio Eradication Initiative, 30 May 2013)
As of 1 Jul, 25 cases had been reported from Somalia (primarily from Banadir region) and six from Kenya (Dadaab in north-eastern Kenya) (Global Polio Eradication Initiative, 1 Jul 2013). As of 14 Aug, Somalia had the worst outbreak in the world in a non-endemic country with 105 cases confirmed. About 10 cases of wild polio had been confirmed in Kenya. (OCHA, 15 Aug 2013) As of 14 Oct, six cases of polio had been confirmed in Ethiopia (IFRC, 25 Oct 2013). Three cases had been reported in South Sudan, but were retracted on 26 Oct due to laboratory error (IFRC, 29 Oct 2013).
As of the end of 2013, the polio outbreak in the Horn of Africa was on the decline and the total number of polio cases stood at 203 (183 from Somalia, 14 from Kenya and six from Ethiopia). The most recent case in the region had onset of paralysis on 9 Oct (from Lower Shabelle, Somalia). (Global Polio Eradication Initiative, 24 Dec 2013)
By 18 Jun 2014, the total number of cases in the region was 219 since the beginning of the outbreak in Apr 2013 (195 from Somalia, 14 from Kenya and 10 from Ethiopia). (Global Polio Eradication Initiative, 18 Jun 2014)
Two new cases of circulating vaccine derived poliovirus type 2 (cVDPV2) were reported in South Sudan in the week of 4 Nov. Both were from Rubkona district of Unity province. The most recent onset of paralysis was on the 12 Sep. (Global Polio Eradication Initiative, 4 Nov 2014)
By 18 Feb 2015, it had been six months since the most recent case of wild poliovirus on the African continent had onset of paralysis, in Somalia on 11 Aug 2014. Twelve months of absence of wild poliovirus, with certification-quality surveillance, will be necessary for the Horn of Africa outbreak to be declared as closed. (Global Polio Eradication Initiative, 18 Feb 2015)
In the second half of 2014, the outbreaks in the Horn of Africa, central Africa and the Middle East that spanned 2013 and the first half of 2014 were brought to the verge of being stopped. Thanks to regionally-coordinated outbreak responses in all three regions, one case was reported in this six-month period, in Somalia on 24 August. No case has been reported from any of the outbreaks since then. Status Report July - December 2014: Progress against the Polio Eradication and Endgame Strategic Plan 2013-2018, published 15 May 2015 (Global Polio Eradication Initiative, WHO)
The Global Polio Eradication Initiative (GPEI) leadership agreed at the time of the 2013–2018 Polio Eradication and Endgame Strategic Plan (PEESP) development that the programme would regularly assess progress, reflect on the lessons learned, plan for the risks ahead, and make needed adjustments to the activities and costs of the plan going forward. This midterm review (MTR) was conducted by a team from the GPEI partners under the guidance of the Strategy Committee (SC) from March-May 2015.
Surveillance Officers like Amina Ismail in Kenya spend their days chasing the poliovirus to its final hiding places, so that it can be stopped forever.
Eradicating polio from the world forever will be one of the biggest public health achievements of our time. Surveillance Officers like Amina Ismail, working for the World Health Organization, know that it is not just vaccinating every last child but being able to trace every last virus that will take us over the finishing line to eradication.
Continent is on the way to finally being rid of the disease, but violent conflicts, particularly in Somalia and Nigeria, pose threat to immunisation programme
Africa has achieved a year without any new cases of wild polio for the first time, but experts warn that violent insurgencies could yet prove their “achilles heel” in finally eradicating the disease.
Mogadishu, 11 August 2015 — Today marks the one-year anniversary of the last reported case of polio in Somalia. To mark the occasion, the Deputy Special Representative of the Secretary-General for Somalia and Humanitarian Coordinator, Peter de Clercq, participated in a vaccination campaign for children at the Medina IDP Camp in Mogadishu.
Joined by representatives of the World Health Organization and UNICEF, Mr de Clercq praised the work of national health authorities, Somali volunteers and the international community to stop the outbreak of Polio in Somalia that began in 2013.
A high-level visit to Selam Health Centre in Addis Ababa this month marked continuing commitment to keeping Ethiopia polio-free
• Acute food insecurity and high levels of malnutrition: 3 million people are in need of life-saving assistance and livelihood support, of which 731,000 are unable to meet their basic food requirements. 203,000 children are acutely malnourished, with around 38,000 of these children at risk of death without health and nutrition support.
In this issue:
How Surveillance Works
Containing a Polio Outbreak: Horn of Africa and Central Africa
Review of the Polio Eradication and Endgame Strategic Plan
Global Voices in Support of Polio Eradication
309 Update on vaccine-derived polioviruses worldwide, January 2014–March 2015
309 Le point sur les poliovirus dérivés de souches vaccinales détectés dans le monde, janvier 2014-mars 2015
An Independent Outbreak Response Assessment in Equatorial Guinea took place last week with over a year since the most recent case of polio on the 3 May 2014. They concluded that there is no evidence that wild poliovirus continues to circulate in the country and that there has been a significant improvement in surveillance. Strengthening routine immunization was identified as the highest priority for sustaining the gains of the outbreak response.
The external assessment team that conducted the final Polio outbreak assessment in Ethiopia earlier this month has confirmed that Ethiopia has successfully interrupted the transmission of the Wild Polio Virus outbreak nearly two years after the outbreak was confirmed in the Horn of Africa.
The South Sudanese Government delegation began consultative talks in Addis Ababa (Ethiopia) prior to the African Union (AU) Heads of State Summit in South Africa (16-17 June 2015). The Summit is expected to discuss the proposed new format of the talks including the Troika countries (United States of America, United Kingdom and Norway), the Intergovernmental Authority on Development (IGAD), China and five other members of the AU.
This week, the “Written Declaration on EU Support and Funding for Polio Eradication” was signed by a majority of the members of the European Parliament. In total, 380 European Parliamentarians signed the Written Declaration, which calls for continued commitment to polio eradication by the European Commission. More
Nigeria and the whole continent of Africa is on the cusp of being polio free, Dr. Hamid Jafari told audience members at the Rotary Convention on 8 June in São Paulo, Brazil.
The recent intensification of conflict has continued to take a heavy toll on children with a total of 161 incidents of grave child rights violations reported this year, 84 of which have been reported from Unity State in May alone. This includes the verified killing of 95 children and unverified reports of large scale use of children by the all sides to the conflict. Unverified reports of similar grave child rights violations have been reported in Upper Nile State.
SOUTH SUDAN: On 18 and 23 May, UNHCR together with local authorities and the host community organized official ceremonies to hand over agricultural land to refugees in Kaya, Yusuf Batil and Gendrassa camps. The host community provided 3,295 ha in Kaya and 431 ha in Yusuf Batil and Gendrassa camps in 2015. Refugee communities have started demarcation and allocation of land. To increase refugees’ self-reliance, UNHCR and its partners are supporting refugees with the distribution of seeds.
HIGHLIGHTS - Since April 2015, UNHCR has been providing over 110 satellite phone call services to some of the South Sudanese displaced in the Protection of Civilian (POC) site in Wau (Western Bahr el Ghazal State) helping families restore contact with their relatives among four of South Sudan's ten states. These satellite calls help IDPs to talk with their families across conflict frontlines and to discover family members they thought were killed in the conflict. Each family is provided with a ten minute time slot, with UNHCR personnel supervising at both ends.
Oxfam, UNICEF and local partner Hijra developed a mobile phone based health promotion project in Somalia to support Polio prevention and control which began in November 2013. The project was implemented with two complementary components: pre-emptive community education delivered through interactive SMS on Polio prevention and distribution of water and sanitation items through SMS voucher redemption. This evaluation recommends that mobile phones are a relevant mechanism to deliver health and WASH information in Somalia.
· The situation in South Sudan has drastically deteriorated in the past two weeks, with heavy fighting on-going across Unity and Upper Nile states. 100,000 people have been displaced and 650,000 have been cut off from aid as humanitarian organizations have been forced to withdraw from affected areas.
May 22, 2015 / 64(19);527-531
José E. Hagan, MD1,2; Steven G.F. Wassilak, MD2; Allen S. Craig, MD2; Rudolf H. Tangermann, MD3; Ousmane M. Diop, PhD3; Cara C. Burns, PhD4; Arshad Quddus, MD3 (Author affiliations at end of text)
HIGHLIGHTS IN SOUTH SUDAN
In a statement issued on 20 May 2015, the United Nations Secretary General Ban Ki-moon strongly condemned the escalation of hostilities in the past ten days between the Sudan People's Liberation Army (SPLA) and the SPLA in Opposition and their allied forces in Unity and Upper Nile States.